In Honduras, Fighting HIV/AIDS Through Music And Theater

Women meet during a support group for those who have HIV and their friends and family on Jan. 17 in Triunfo de la Cruz. These kinds of support groups are an important part of making people feel comfortable with their diagnosis and seeking treatment.

A view of a cemetery in Sambo Creek. Before medicines were made widely available in the early 2000s, scores of people in the Garifuna community died from AIDS. According to local NGOs, the death rate has dropped dramatically.

Women meet during a support group for those who have HIV and their friends and family on Jan. 17 in Triunfo de la Cruz. These kinds of support groups are an important part of making people feel comfortable with their diagnosis and seeking treatment.

Anatolia Ramirez waits outside the home of one of the HIV-positive women she visits in Sambo Creek. Ramirez is a community health worker who visits people with HIV in order to check up on them, and to offer assistance and support.

Nolvia Cruz waits to be seen at an HIV/AIDS health clinic on Jan. 25 in La Ceiba. Nolvia is open about her diagnosis, but many people are afraid to go to the clinic for fear that someone they know will see them and gossip about their HIV status.

Carmen Suyapa (right) receives a visit from Anatolia Ramirez on Jan. 21 in La Ceiba, Honduras. Carmen felt so rejected by her family after she was diagnosed with HIV that she briefly considered committing suicide.

David Rochkind
/ Pulitzer Center

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Originally published on March 29, 2013 11:14 am

In the village of Corozal in Honduras, men ready boats for fishing excursions and boys play soccer on a beach lined with thatched huts.

On a sandy lot next to the town's main street, two teenage boys begin playing drums while women sing. For centuries, this has been the signature sound of celebration for the Garifuna, an Afro-Caribbean people on the Atlantic coast of Central America. Now this music has an additional purpose: to prevent HIV.

As people arrive to hear the drumming, the musicians become actors in a play. The plot centers on a court case: The Garifuna are putting HIV itself on trial.

"The virus is orphaning children and tearing apart families," Eduardo Marcial Garcia, who plays the prosecutor, says in Spanish.

High HIV Rate

According to the U.S. Centers for Disease Control and Prevention, 4.5 percent of the Honduran Garifuna population has HIV — a proportion that is five times as high as in the country as a whole, according to the government. No nation in the Western Hemisphere has a rate that high.

Local Garifuna woman Carmen Suyapa contracted the virus from the father of her two daughters. He hadn't told her he was HIV-positive. She didn't know medicine existed and thought she was destined to die. Family members stayed away from her because she was sick, and she says she couldn't get a job because she had the virus.

Suyapa, who is now 37, was so distraught, she says she almost killed herself and her baby. Instead she left the father, and luckily her daughters didn't contract HIV. But she waited years to seek medical treatment.

Suyapa hid away, she says, because she couldn't bear other people laughing at her.

'A Major Problem'

Not far away, a state-funded HIV clinic provides access to doctors and anti-AIDS medicine at almost no cost.

Factors contributing to the high HIV rate include a lack of education, widespread poverty and heavy migration, as men tend to find work on cruise ships and fishing boats that frequent ports rife with the virus. Locals also say HIV spreads because it can be culturally acceptable to have sex with multiple partners.

Dr. Mercy Garcia says people deny having the problem because they are afraid of being judged. The key, he says, is to provide education that helps change behavior.

Ana Vilma Silva is a 37-year-old Garifuna woman who participates in theater groups. She and one of her three daughters were both diagnosed with the virus 11 years ago.

"HIV is a major problem because some people don't understand it," she says. "Some young people think HIV doesn't even exist."

She says theater and other community groups help address this because they engage people more than pamphlets or books do. Garcia, the actor portraying the prosecutor, says there's proof of that. He says his performances have inspired more young people to join the theater group, which has 30 members. He says they now lead safer lives.

Looking For Small Victories

About 220 miles away, in the capital of Tegucigalpa, health ministry officials are eager for data on the effectiveness of this approach. They are completing a new study with the CDC on HIV prevalence among the Garifuna. If the rate falls from 4.5 percent, it could indicate that educational programs like theater groups are working. The U.S. Agency for International Development and the Honduran government have both funded theater groups including the one in Corozal.

Kellie Stewart, director of the Honduras health office for USAID, says though she can't speak for the CDC study, she has seen an improvement.

"We have observed a substantial decline in the number of positive HIV tests among beneficiaries of USAID's program in the community," she says.

Back in Corozal, the theater troupe is finishing its play. The prosecutor and defense attorney have given their arguments in the court case against HIV. But narrator Yilian David says the court decides there's no verdict. The reason? HIV is still a major problem, she says. The Garifuna can't declare victory yet.

Jens Erik Gould's reporting from Honduras was supported by a grant from the Pulitzer Center on Crisis Reporting

Copyright 2013 NPR. To see more, visit http://www.npr.org/.

Transcript

DAVID GREENE, HOST:

It's MORNING EDITION from NPR News. Good morning. I'm David Greene.

RENEE MONTAGNE, HOST:

And I'm Renee Montagne. We're going to hear, now, about an unusual approach to combating an epidemic of HIV/AIDS. It involves a culture of storytelling in Honduras, a long tradition one group there is using to fight the spread of the virus. From the coast of Honduras, reporter Jens Erik Gould has more.

(SOUNDBITE OF OCEAN WAVES)

JENS ERIK GOULD, BYLINE: In the village of Corozal, men ready boats for fishing excursions and boys play soccer on a beach lined with thatched huts.

(SOUNDBITE OF DRUMMING, SINGING)

GOULD: On a sandy lot next to the town's main street, two teenage boys begin playing drums while women sing. For centuries, this has been the signature sound of celebration for the Garifuna - an Afro-Caribbean people on the Atlantic coast of Central America. Now this music has an additional purpose - to prevent HIV.

(SOUNDBITE OF PLAY)

UNIDENTIFIED MAN #1: (Spanish spoken)

UNIDENTIFED GROUP: (Spanish spoken)

GOULD: As people arrive to hear the drumming, the musicians become actors in a play.

(APPLAUSE)

GOULD: The plot centers around a court case. The Garifuna are putting HIV itself on trial. Eduardo Marcial Garcia plays the prosecutor.

(SOUNDBITE OF PLAY)

EDUARDO MARCIAL GARCIA: (As prosecutor) (Spanish spoken)

GOULD: He says the virus is orphaning children and tearing apart families. According to the U.S. Centers for Disease Control and Prevention, 4.5 percent of the Honduran Garifuna population has HIV. To put it in perspective, that's five times as high as the country of Honduras, according to the government. No nation in the Western Hemisphere has a rate that high.

CARMEN SUYAPA: (Spanish spoken)

GOULD: That's local Garifuna woman Carmen Suyapa , Suyapa contracted the virus from the father of her two daughters. He hadn't told her he was HIV positive. She didn't know medicine existed, and thought she was destined to die. Family members stayed away from her because she was sick. And she said she couldn't get a job because she had the virus.

SUYAPA: (Spanish spoken)

GOULD: Suyapa - who is now 37 - was so distraught she says she almost killed herself and her baby. She didn't. She left the father and luckily her daughters didn't contract HIV. But she waited years to seek medical treatment.

SUYAPA: (Spanish spoken)

GOULD: Suyapa hid away, she says, because she couldn't bear other people laughing at her. Not far away, a state-funded HIV clinic provides access to doctors and anti-AIDS medicine at almost no cost.

Factors contributing to the high HIV rate include a lack of education, widespread poverty and heavy migration - as men tend to find work on cruise ships and fishing boats that frequent ports rife with the virus. Locals also say HIV spreads because it can be culturally acceptable to have sex with multiple partners.

DOCTOR MERCY GARCIA: (Spanish spoken)

GOULD: Dr. Mercy Garcia, who works at the clinic, says people deny having the problem because they're afraid of others judging them. The key, the doctor says, is to provide education that helps change behavior.

ANA VILMA SILVA: (Spanish spoken)

GOULD: Ana Vilma Silva is 37-year-old Garifuna woman who participates in theatre groups. She and one of her three daughters were both diagnosed with the virus 11 years ago.

SILVA: (Spanish spoken)

GOULD: Silva says HIV is a major problem, because some people don't understand it or don't even believe it exists. She says theatre and other community groups help address this, because they engage people more than pamphlets or books. Eduardo the actor says there's proof of that.

GARCIA: (Spanish spoken)

GOULD: He says his performances have inspired more young people to join the theater group which has 30 members. He says they now lead safer lives.

(SOUNDBITE OF TRAFFIC)

GOULD: Two hundred-twenty miles away, in the capital of Tegucigalpa, health ministry officials are eager for data on the effectiveness of this approach. They're completing a new study with the CDC on HIV prevalence among the Garifuna. If the rate falls from 4.5 percent, that could indicate educational programs like theatre groups are working.

Kellie Stewart is director of the Honduras health office for USAID. The U.S. government agency and the Honduran government have both funded theatre groups, including the one in Corozal. While she can't speak for the CDC study, she's seen an improvement.

KELLIE STEWART: We have observed a substantial decline in the number of positive HIV tests among beneficiaries of USAID's program in the community.

(SOUNDBITE OF PLAY)

UNIDENTIFIED MAN #2: (Spanish spoken)

UNIDENTIFIED WOMAN: (Spanish spoken)

GOULD: Back in Corozal, the theatre troupe is finishing its play. The prosecutor and defense attorney have given their arguments in the court case against HIV.

(SOUNDBITE OF PLAY)

YILIAN DAVID: (Spanish spoken)

GOULD: But narrator Yilian David says the court decides there's no verdict. The reason? HIV is still a major problem, she says. The Garifuna can't declare victory yet. For NPR News, Jens Erik Gould.

MONTAGNE: And this reporting from Honduras was supported by a grant from the Pulitzer Center on Crisis Reporting. Transcript provided by NPR, Copyright NPR.